CN106132317A - Process the pincer system of bodily tissue - Google Patents
Process the pincer system of bodily tissue Download PDFInfo
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- CN106132317A CN106132317A CN201580013866.9A CN201580013866A CN106132317A CN 106132317 A CN106132317 A CN 106132317A CN 201580013866 A CN201580013866 A CN 201580013866A CN 106132317 A CN106132317 A CN 106132317A
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- mounting rod
- endoscope
- clamp
- holder arms
- coupling part
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/128—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
- A61B17/1285—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips for minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00131—Accessories for endoscopes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/064—Surgical staples, i.e. penetrating the tissue
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/0682—Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/08—Wound clamps or clips, i.e. not or only partly penetrating the tissue ; Devices for bringing together the edges of a wound
- A61B17/083—Clips, e.g. resilient
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/10—Surgical instruments, devices or methods, e.g. tourniquets for applying or removing wound clamps, e.g. containing only one clamp or staple; Wound clamp magazines
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/122—Clamps or clips, e.g. for the umbilical cord
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/122—Clamps or clips, e.g. for the umbilical cord
- A61B17/1227—Spring clips
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/00296—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means mounted on an endoscope
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/064—Surgical staples, i.e. penetrating the tissue
- A61B2017/0645—Surgical staples, i.e. penetrating the tissue being elastically deformed for insertion
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Molecular Biology (AREA)
- General Health & Medical Sciences (AREA)
- Veterinary Medicine (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Public Health (AREA)
- Animal Behavior & Ethology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Reproductive Health (AREA)
- Vascular Medicine (AREA)
- Physics & Mathematics (AREA)
- Biophysics (AREA)
- Optics & Photonics (AREA)
- Pathology (AREA)
- Radiology & Medical Imaging (AREA)
- Surgical Instruments (AREA)
- Endoscopes (AREA)
Abstract
A kind of device compressing bodily tissue, including clamp, described clamp includes the coupling part that the first and second holder arms extend from it, described clamp includes the recess being formed on the inner surface of described coupling part, the shape and size of described recess are confirmed as slideably received within mounting rod, described mounting rod is coupled to the outer surface of the endoscope that described mounting rod is installed on it, contact between the endoscope and the inner surface of described first and second holder arms that are installed on it by described mounting rod, the described inner surface of described first and second holder arms is maintained at open position.Described clamp can slide on the described outer surface of the endoscope that described mounting rod is installed on it, until described clamp is moved distally the described far-end exceeding the endoscope that described mounting rod is installed on it so that the first and second holder arms elastic closures are to clamp the tissue between them.
Description
The cross reference of related application
This application claims, the pincer system of entitled process bodily tissue ", in proposition on January 17th, 2014, Serial No.
The priority of the U.S. Provisional Patent Application of 61/928,783, entire contents is herein incorporated by reference.
Background technology
The present invention relates to process the system and method for bodily tissue, particularly relate to compress pincer system and the side of bodily tissue
Method.
It is typically used for surgical clamp, such as, in order to keep bodily tissue or by health in various medical procedure
Tissue is clipped together, and extruding blood vessel or other body cavitys are hemorrhage etc. to prevent.Clamp can use various method to be introduced into patient
Internal, such as subcutaneous methods and Minimally Invasive Surgery method.In subcutaneous methods, the skin that can penetrate patient enters body cavity with clamping
Clamp around target treatment position is used for closing.In Minimally Invasive Surgery method, the clamp with a pair arm can use endoscope to lead to
The natural dissection opening crossing such as mouth is incorporated into patient body and is arranged.
Some treatment requires to arrange multiple clamp in vivo.Many traditional systems the most only deliver a clamp, and
Must remove from health to load the new clamp being then delivered to the second target treatment position, repeat this process until requirement
Clamp be arranged.As a result, multiple clamp complexity and time-intensive, expensive are arranged.
Summary of the invention
One embodiment includes a kind of system compressing bodily tissue.Described system includes mounting rod, clamp and control portion
Part.Described mounting rod includes the draw bail being arranged in endoscope by described mounting rod so that described mounting rod is along endoscope
Far-end part extend, mounting rod be parallel to endoscope the longitudinal axis install.Described clamp include the first and second holder arms from
Its coupling part extended.The inner surface of described coupling part includes that recess, the shape and size of described recess are determined to be in
The inner surface of the first and second holder arms by with while the contacting and be maintained at open position of described endoscope, slidable receipt
Described mounting rod.Described control parts are connected to described clamp, to move described clamp along described mounting rod, until described clamp
It is moved distally the described far-end exceeding endoscope, it is allowed to the first and second holder arms elastic closures and clamping are received in it
Tissue between.
Another embodiment includes a kind of device compressing bodily tissue.Described device includes that clamp, described clamp include
The coupling part that first and second holder arms extend from it.The inner surface of described coupling part includes recess, the shape of described recess
Shape and be dimensioned so as to the mounting rod that slidable receipt is connected to the outer surface of the endoscope that described mounting rod is installed on it.The
One and second the inner surface of holder arms by being maintained at open position with contacting between described endoscope.Described clamp can be in institute
The described outer surface stating the endoscope that mounting rod is installed on it slides above, until described clamp be moved distally exceed described in
The described far-end of sight glass so that the tissue that the first and second holder arms elastic closures are received between them with clamping.
Include a kind of method compressing bodily tissue the most in another embodiment.Described method includes advancing mounting rod
The endoscope being installed on it is to intravital target position.The endoscope that described mounting rod is installed on it is equipped with multiple clamp, institute
State multiple clamp to be arranged on above its outer surface.Each clamp includes the coupling part that the first and second holder arms extend from it.
Each clamp is included in the recess on the inner surface of described coupling part, and the shape and size of described recess are confirmed as slidably connecing
Receive described mounting rod so that the outer surface of described endoscope keeps the inner surface of described first and second holder arms at open position
Separated from one another.Described method farther includes to be incorporated into tissue described endoscope, and actuation control parts are with sliding towards distally
A dynamic farthest clamp exceedes the described far-end of described endoscope and described mounting rod so that the first and second holder arms are elastic
Close the described tissue being introduced in described endoscope with clamping.
Accompanying drawing explanation
It is incorporated to this specification and constitutes the accompanying drawing of this specification part, it is shown that the exemplary embodiment of the present invention,
And together with describing with word, it is used for explaining the operation principle of the present invention.
Fig. 1 is the diagrammatic side view of the first exemplary embodiment of the clamp being in expansion form；
Fig. 2 is the diagrammatic side view of the second exemplary embodiment of the clamp being in expansion form；
Fig. 3 is the diagrammatic side view of the 3rd exemplary embodiment of the clamp being in expansion form；
Fig. 4 and Fig. 5 shows the mechanism advancing clamp in the exemplary pincer system compressing tissue；
Fig. 6 is the schematic diagram of the exemplary mounting rod of the pincer system of Figure 4 and 5；
Fig. 7 is the fragmentary sectional side view of the mounting rod of Fig. 6；
Fig. 8 is the sectional view of the mounting rod of Fig. 6；
Fig. 9 is the sectional view of the push mechanism of the pincer system of Figure 4 and 5.
Detailed description of the invention
The most in detail with reference to embodiments of the invention, described embodiment is shown in the drawings.As possible, all of attached
Figure uses identical reference to represent same or analogous parts.
Embodiments of the invention relate to the system and method for compressing bodily tissue.One is configured to receive and cloth
Put multiple clamp to bodily tissue without the system removing system from health.This system sight glass that is included is installed above
Mounting rod, including the clamp of coupling part, described coupling part has the first and second holder arms extended from it, and couples
Control parts to described clamp.The longitudinal axis that mounting rod is parallel to endoscope along the distal portions of endoscope extends.Clamp includes
Being formed at the recess on the inner surface of coupling part, the shape and size of described coupling part are confirmed as slideably received within installation
Bar, the inner surface of described first and second holder arms is maintained at by the contact of endoscope and the first and second holder arms inner surfacies
Open position.Control parts include push mechanism and be distally connected to the seal wire of push rod.Push mechanism and clamp be related with
Clamp is advanced until farthest clamp is moved distally exceedes the far-end of endoscope and mounting rod so that first and the along mounting rod
Two holder arms elastic closures are to clamp bodily tissue between which.
Those skilled in the art is it will be appreciated that the present invention can show in a variety of manners, and is not limited to described here
With the certain specific embodiments considered.Therefore, it can be changed in form and details, without departing from claims
Scope and spirit of the present invention described by book.
Fig. 1 is the diagrammatic side view of the first exemplary embodiment of the clamp 100 being in expansion form.Clamp 100 includes
There is the first holder arms 104a and the coupling part 102 of the second holder arms 104b.The coupling part 102 of each clamp 100 is arranged
For extending the bottom of holder arms 104a and 104b, and include that size and dimension is determined to receive mounting rod 114
Recess 112.First and second holder arms 104a and 104b have respective first end 106a and 106b.First end 106a, 106b
Extending to holder arms 104a and 104b respective free end 108a, 108b, described holder arms 104a and 104b has around first
End 106 restrictive elasticity so that clamp 100 be partial to clamp form, in described clamping form, free end 108a and
108b is furthered each other.When being installed in endoscope, arm 104a and 104b is by receiving endoscope between which
Body maintain separately from each other open form.Holder arms 104a and 104b deflection upcountry moves radially so that the first clamp
The first free end 108a of arm 104a can be formed with the second free end 108b of the second holder arms 104b and contact or substantially close
Close.In this embodiment, the thickness of first end 106 of holder arms 104a, 104b of each clamp 100 is more than the thickness of free end 108
Degree, with reinforcement clamp tong arm 104 and strengthen towards clamping form deflection.Such as, holder arms 104a, 104b the first end 106 is bigger
Thickness, on holder arms 104a, 104b apply recurrence power so that holder arms 104a, 104b are not having any outside stimulus
In the case of be partial to clamp form.Holder arms 106a, 106b can with variously-shaped structure, include but not limited to triangle,
Irregularly shaped etc..In the example illustrated, holder arms 104a, 104b are shaped as from corresponding first end 106 to freedom
The part of end 108 extension is crescent.In the exemplary embodiment, at coupling part 102 thickness of clamp more than free end 108a,
Thickness at 108b is to contribute to the flexibility of first and second arm 104a, 104b, and wherein thickness can be chosen so as to meet clamp
Flexibility required for 100 application-specific, as will be appreciated by those of skill in the art.
First and second holder arms 104a, 104b defining respective respective first inner surface 110a and the second inner surface
110b.The corresponding shape (not shown) of endoscope exterior surface that they will be installed to of the shape of inner surface 110a, 110b.Example
As, the inner surface 110 of holder arms 104a, 104b can be with forming part circular arc, and described circular arc has will with holder arms 104a, 104b
The diameter that the overall diameter of the circular endoscope being installed to is equal.Inner surface 110 or its part, such as the first holder arms 104a
Inner surface 110a, it is possible to use any suitable biocompatible substance as known in the art process, to increase holder arms
Frictional force between 104a, 104b and received endoscope.In certain embodiments, inner surface 110 can include using ability
Known different chemical and the projection of mechanical technique in territory, depression, fold or similar micro-pattern, to strengthen and the rubbing of body
Wipe and engage.In another embodiment, can process the part of inner surface 110 or inner surface with reduce holder arms 104a,
Frictional force between 104b and endoscope, it is therefore an objective to such as, contributes to the clamp 100 layout from endoscope.Can be with selected
Mode constructs inner surface 110 and most preferably retains with promote clamp 100 in endoscope to strengthen frictional force, is preventing clamp 100
While the layout of endoscope is hindered, promotes that clamp 100 leaves the optimal placement of endoscope, and contribute to clamp
100 postpone the reservation in target tissue site at cloth.Such as, inner surface 110 can have base station and/or a groove, described base station and/or
Slot fit enters groove corresponding on endoscope exterior surface and/or base station.Additionally, holder arms 104a, 104b are configured with selected
Spring constant so that holder arms 104a, 104b are by radially inward towards promoting to each other to keep the frictional engagement with endoscope.This
Outward, the outer surface of holder arms 104a, 104b is optional is coated with medication coat, and described medication coat can be such as pentoxifylline
Alkali (PTX) and the mixture of excipient (such as, loperamide).But, medication coat can be based on expection therapeutic effect and
Any suitable medicine of area for treatment and the combination of excipient.
Clamp 100 also includes the recess 112 being formed on the inner surface of coupling part 102.The shape and size quilt of recess 112
Being defined as receiving mounting rod 14, described mounting rod 114 can be removably coupled to the outer surface of endoscope.Mounting rod
The lower surface of 114 can be formed has curvature, and this curvature meets this mounting rod 114 by the curvature of endoscope mounted thereto.
Recess 112 includes the first wall 116a, the second wall 116b and the 3rd wall 116c.3rd wall 116c is at the first and second walls
Extend between 116a, 116b.Wall 116a, 116b, 116c can have different towards making recess 112 have suitable cross section
Shape, includes but not limited to meet the ellipse of mounting rod 114 cross sectional shape, circular and T-shaped.In the first embodiment, as
Shown in figure, the first wall 116a and the second wall 116b can extend into coupling part 102 with contrary angle.3rd wall 116c
Can be plane, and bend to receive substantially curved mounting rod 114.The curvature correspondence bending the 3rd wall 116c connects
The curvature of part 102 inner surface.In one embodiment, wall 116a, 116b can surround approximation 20-60 ° together with axis 115
Angle α, its axis 115 divides clamp 100 equally, as shown in fig. 1.It should be understood, however, that the most also
It is contemplated that other angle.
As shown in Figure 2, according to the clamp 200 of the second embodiment, there are the parts similar with the parts of clamp 100, and
The parts of these correspondences are given the numbering being previously mentioned with Fig. 1 clamp 100 and are identically numbered.These parts include coupling part
102, there is holder arms 104a, 104b of the first end 106, free end 108 and inner surface 110.These parts are with the clamp with Fig. 1
The substantially the same mode of mode described in the explanation of 100 each operates.Compared with clamp 100, clamp 200 recessed
Portion 202 is configured to receive mounting rod 204, as shown in Fig. 6-8 in further detail.Recess 202 include the first wall 206a and
Second wall 206b, it is substantially parallel and corresponding to connecting portion that both are substantially perpendicular to the 3rd wall 206c, described 3rd wall 206c
Divide the inner surface of 102.Recess 202 also includes shoulder 208a, 208b, and described shoulder 208a, 208b are by recess 202 and inner surface
110a, 110b axial separation.Therefore, recess 202 axially divides with the cavity surrounded by first and second holder arms 104a, 104b
From.Shoulder 208a, 208b keep clamp 200 on mounting rod 204 so that clamp 200 can not separate from mounting rod 204 until pressing from both sides
Pincers 200 are moved distally and leave mounting rod 204.Therefore, mounting rod 204 can use any shape, peeps without in meeting
The outline of mirror.
Mounting rod 204 forms the cross section with substantial rectangular.Prolonging away from endoscope under operation form of mounting rod 204
The upper surface 205 stretched includes silk guide passage 208.Silk guide passage 208 is formed as axial groove, and described axial groove prolongs with the selected degree of depth
Extend into mounting rod 204 to accommodate wherein by seal wire 416, as will be described in further derail below.In exemplary enforcement
In example, silk guide passage 208 can have square-section, although within the scope of the invention it is also contemplated that other cross section shape
Shape.Silk guide passage 208 extends to, from the near-end 209 of mounting rod 204, the far-end 211 that the far-end 405 with endoscope 404 aligns.?
In one embodiment, silk guide passage 208 can be open towards the upper surface 205 of mounting rod 204.In another embodiment (not
Illustrate), silk guide passage 208 can be enclosed in mounting rod 204, and its split shed is formed at it proximally and distally can with permission seal wire
It is slidably inserted into by it.As shown in the partial cross section view of Fig. 7, at far-end 211, silk guide passage 208 is towards guidewire lumen
218 is open, and described guidewire lumen 218 extends through mounting rod 204 from upper surface 205 to lower surface 207.In one embodiment,
Guidewire lumen 218 has substantially circular cross section to allow seal wire 416 to be inserted through.It should be understood, however, that without departing from this
Any other cross sectional shape can be used in the case of invention scope.Guidewire lumen 218 can upper table at silk guide passage 208
Face 205 is to lower surface 207 along crooked route.(not shown) in another embodiment, guidewire lumen 218 from upper surface 205 to
The path that surface 207 extends along the longitudinal axis being perpendicular to mounting rod 204 straight line portion extends.The most in another embodiment (the most not
Illustrate), guidewire lumen 218 extends along angle from upper surface 205 to lower surface 207.Although it should be noted that, embodiment is described
There is the seal wire 416 extending through mounting rod 204, within the scope of the invention it is also contemplated that other path.At another
(not shown) in embodiment, seal wire 416 can pass through between mounting rod 204 and endoscope 404.
Seal wire 416 can be made up of any suitable biocompatible materials, and described material has enough flexibilities
With described seal wire 416 along zigzag path by arriving internal target position time through endoscope 404.Such as, the flexibility of seal wire 416 can
With substantially greater than mounting rod 204 and the flexibility of endoscope 404.
When mounting rod 204 is installed to endoscope 404 in desired position, guidewire lumen 418 is in endoscope 404
The guidewire track 412 extended in distal openings is open, and guidewire track 412 guides the seal wire 416 from mounting rod 204 to enter into interior
The service aisle 418 of sight glass 404.As shown in figures 4 to 7, guidewire track 412 is the projection including track 602, and its shape is by really
It is set to and guides seal wire 416 along booking path.In the exemplary embodiment, guidewire track 412 is for being permanently attached to mounting rod 204
" D " shape parts so that its curved surface 415 is towards distally.In operation form, curved surface 415 provides guiding endoscope 404 far-end
On seal wire 416 enter into the path of service aisle 418.Track 602 be formed as along curved surface 415 extend elongated groove with
Wherein receive seal wire 416.The part (such as, shield or lip) that diameter reduces can be positioned at the elongated of track 602
To prevent seal wire 416 from undesirably falling off on groove.In another embodiment, track 602 can be formed through guidewire track 412
The passage extended enters into endoscope path way 418 with guiding seal wire 416 by it.
First and second lateral sidewalls 210,212 of mounting rod include being parallel to the first of the longitudinal axis extension of mounting rod 204
With the second wing passage 214,216.First and second wing passages 214,216 are formed as extending into mounting rod 204 selected depth
Groove, with engage be positioned between each clamp 100 correspondence paired intermediate bar 500, the most as will be described in more detail.
First and second wall 206a, 206b of recess 202 include projection 203, are sized to be received in first and second
To prevent intermediate bar 500 to be received in wherein in wing passage 214,216.
Intermediate bar 500 is slidably received in the first and second wing passages 214,216, and is used for clamp 100
Predetermined distance separated from one another.This separation allows clamp 100 individually to arrange and do not interfere with each other.Under operation form, work as edge
Mounting rod 204 slides when advancing clamp 100, and intermediate bar 500 also slides to maintain between adjacent clamp 100 phase along mounting rod 204
The interval hoped.A farthest clamp 100 move away mounting rod 100 and be arranged in internal after, it is allowed to intermediate bar 500 slips away
First and second wing passages 214,216.Intermediate bar 500 then can use known Repossession method to fetch from health, or
Another embodiment can be left in place.Intermediate bar 500 is made up of flexible biocompatible material.
Such as Fig. 4, as shown in 5 and 9, push mechanism is formed has rectangular shape, and described rectangular shape has Matching installation bar
The opening 412 of the outline of 204.Specifically, opening 412 substantially rectangle.First and second sidewalls 414 of opening 412,
416 include that the first and second projections 418,420, the size and dimension of described first and second projections 418,420 are determined to
Engage intermediate bar 500.Push mechanism 410 makes the first and second projections 418,420 in centre along the distal movement of mounting rod 204
The distal press of correspondence is applied to cause the distally of clamp 100 to advance, as hereafter illustrative methods will in further detail on bar 500
Describe.The upper wall 422 of opening 412 includes the projection 424 extending into opening 412, and is sized to slide
Dynamic joint silk guide passage 208.Projection 424 includes the seal wire attachment point 426 receiving seal wire 416 free end.Push mechanism 410 is permissible
Use ratchet engagement to engage mounting rod 204 and make push mechanism only towards distal direction along mounting rod 204 slidably, and folder is provided
Pincers leave the controlled placement of mounting rod 204.
As shown in Figure 3, the clamp 300 as described in the 3rd embodiment has the portion similar with the clamp 200 shown in Fig. 2
Part, and give the parts of these correspondences and the same numbering described in clamp 200.These parts include coupling part
102, there is the holder arms 104a of the first end 106, free end 108 and inner surface 110,104b, recess 202, wall 206 and shoulder
208a、208b.These parts individually operate in the way of substantially the same with described by the clamp 100 and 200 of Fig. 1 and 2.Folder
Pincers 300 include that the second spring structure 310 extended radially outwardly from coupling part 102 (that is, installs it away from clamp 300
On the direction of endoscope).Second spring structure includes the first adjutage 302a and the second adjutage 302b.In some embodiments
In, two adjutages 302a, 302b are substantially parallel to one another.Adjutage 302a, 302b clamp 300 be in expansion form time,
Be suitable rigidity to apply other biasing force to holder arms 104a, 104b, promote clamp 300 towards clamping form.Extend
Arm 302a, 302b can also be pulled towards each other with by drawn apart from one another for holder arms 104a and 104b to move clamp 300 to opening shape
State.But, those skilled in the art it will be appreciated that adjutage 302a, 302b can with any suitably towards or angle
Arrange, change the intensity of the power biasing clamp 300 towards clamping form with expectation.Adjutage 302a as described in the present invention,
302b can provide extra spring bias to be in operation form to retain structural clamp 300.
As shown in Figures 4 and 5, pincer system 400 include the such as mounting rod of mounting rod 204, clamp 402a, 402b,
402c (be referred to as, clamp 402) and include the control parts of push mechanism 410 and seal wire 416, as will be described in further derail below
's.As it can be seen, mounting rod 204 has a cross section of rectangle, but it is also contemplated that other cross sectional shape, such as, but not limited to
Circular, oval, irregularly shaped or similar.Can suitably determine that the shape and size of mounting rod 204 are to be arranged on
In endoscope 404.Mounting rod 204 can also be parallel to the longitudinal axis of endoscope 404 and install.Further, mounting rod 204 includes connection
Access node structure with location and installation bar 204 removedly on the distal portions of endoscope 404.Draw bail (Fig. 6) includes joining
Meet or be not coupled to locking strap 406a, 406b of mounting rod 204.The shape of locking strap 406a, 406b can be circular, although
Other shapes can be considered based on the cross section of the endoscope 404 receiving them thereon.Locking strap as described in this embodiment
406a, 406b extend (Fig. 7) in the plane being mounted substantially perpendicular to bar 204 so that when being installed in endoscope, locking
Bind round and will extend in the plane of the longitudinal axis being perpendicular to endoscope.Once expand, including locking strap 406a, 406b fixed installation bar 204
On the distal portions of sight glass 404.
Mounting rod 204 is installed together with can passing through a pair mounting rod 500 clamp 402 separated from one another with adjacent clamp.
It being understood that in addition to clamp 402, any amount of other clamp can be positioned on mounting rod 204.As it has been described above,
Each clamp includes the recess that cross section is corresponding with mounting rod 204 cross section, such as, recess 202.Mounting rod 204 is received in recess
Make clamp 402 can be positioned at movably on mounting rod 204 in 202.Clamp 402 can be placed on the remote of farthest locking strap
Side, such as locking strap 406a, it is coupled to the mounting rod 204 far-end until endoscope 404.But, as the skill of this area
Art personnel it will be appreciated that, clamp 402 can be installed in one or two nearside in locking strap 406a, 406b, if lock
The shape of the near-end of lock ring 406a, 406b is easy to clamp 402 therethrough and is passed through.Such as, the near-end of locking strap 406a, 406b can
Be taper with allow clamp 404 arm go over time expansion.Mounting rod 204 can be by suitable biocompatibility material
Material is made, and described material has selected flexibility to allow endoscope 404 to be manipulated by as required.
As it can be seen, the far-end 408 of the mounting rod 204 as described in an embodiment bends away from locking strap 406a, 406b,
Making when mounting rod 204 is arranged in endoscope 404 in the position needed, far-end 408 exceedes endoscope 404 towards distal extension
Far-end 405.The far-end 408 of bending helps clamp 402a, 402b, 402c alinement when they pushed away from endoscope.?
In exemplary embodiment, the curvature of the far-end 408 of bending is chosen upper in target tissue site of beneficially clamp 100,200,300
Side's alignment.That is, clamp 100,200,300 is removed the plane of endoscope 404, therefore profit by the curvature of the far-end 408 of bending
In the clamp 100,200,300 visualization when they move apart endoscope.It should be noted that the curvature described in Fig. 4-7
It is merely exemplary, any other curvature can be used without departing from the present invention.Such as, curvature is permissible
Be formed as the far-end of mounting rod 204 slight taper.In another embodiment of the present invention (not shown), mounting rod 204 initially may be used
To be configured to straight line kenel, and can be fabricated from a flexible material.Operation seal wire (not shown) can from surgeon or
The proximal extension of other user contact is to the far-end of the far-end being connected to mounting rod 204.Under operation form, surgeon can
With recovery operation seal wire (not shown) angle needed for the far-end of mounting rod 204 being bent before clamp 100,200,300 is arranged
Degree.Specifically, surgeon is recoverable to operate first that seal wire (not shown) causes mounting rod 204 far-end 408 first to bend
Distance, and cause the second distance more than the first distance of the second bending more than the first bending.
In operation (Fig. 5), mounting rod 204 is installed on the distal portions of endoscope 404 and uses locking
Hoop 406a, 406b are fixed in endoscope 404, and wherein clamp 402 is received on the mounting rod 204 above endoscope 404, its
Middle seal wire 416 is walked around guidewire track 412 from push mechanism 410 and is extended into endoscope path way 418.Should be understood that installation
Bar 204 is the link mechanism coupling clamp 402 to endoscope 404.According to embodiments of the invention, mounting rod 204 can be made
Causing various sizes so that these mounting rods 204 are suitable for and such as bronchoscope, the various mirrors of cystoscope etc. are used together so that
Clamp 402 can be used to compress the various organ tissues of such as lung, bladder etc..
Suitably determine the combination distal portions of the endoscope 404 including mounting rod 204, clamp 402 and push mechanism 410
The size in cross section, be beneficial to smooth advance combined system to arrive required treatment position through body cavity.For example, it is possible to by special
Size makes the combination distal portions of endoscope 404, and special configuration its arrive stomach etc. through esophagus.
In clamp 402, the first and second holder arms of each, such as holder arms 104a, 104b, pacified by mounting rod 204
It is contained in connecing between endoscope 404 thereon and inner surface (the such as inner surface 110 of first and second holder arms 104a, 104b)
Touch and be maintained at open position.Joint between holder arms 104a, 104b and endoscope 404 so that endoscope 404 is navigated at it
By keeping clamp 402 during the health of patient.
At treatment position, target tissue is at least partially introduced into endoscope 404, such as, by being applied across endoscope
The negative pressure of passage 418, such as, uses suction pump.Once tissue is inhaled into the far-end of endoscope 404, and seal wire 416 near-end is (not
Illustrate) actuating cause push mechanism 410 being distally moved along mounting rod 204, described distally is moved and is advanced along mounting rod 204
Clamp 402, until farthest one of clamp 402 is moved distally and exceedes mounting rod 204 and the far-end of endoscope 404.Specifically,
When push mechanism 410 is moved distally, clamp 402 slides until farthest clamp, such as clamp along mounting rod 204 towards distally
402a is moved distally the far-end exceeding endoscope 404.Now, when arm 104a, 104b are no longer by the support of endoscope 404,
They are introduced into the tissue of endoscope 404 inwardly toward each other near clamping.When farthest clamp 402a moves towards distally
When influencing meridian crosses the far-end of mounting rod 204, clamp 402a is released from mounting rod 204 and separates from system 400 completely so that its
The position organized by folder can be left on.
Then can be close to the second target tissue site and reorientate endoscope, and described process can be repeated with by second
Clamp 402b is arranged in this position.The most described process can be repeated as many times as desired, until all of clamp 402 is by cloth
Put, or until all of target tissue site is treated.When last tissue site is processed, and endoscope 404 is moved from health
Walk.As will be appreciated by those of skill in the art, pincer system 400 arbitrary or all parts (such as clamp 402 or
Person's push mechanism 410) can be made up of radiopaque material, or mix it so that use fluoroscopy or other shapes
The x-ray imaging of formula, these parts are visible.Clamp 402 can be by any suitable biocompatibility material as known in the art
Material is made, and can include Biodegradable material, includes but not limited to poly (glycolide-lactide) ((poly (D, L-lactide-
co-glycolide)).As will be appreciated by those of skill in the art, if clamp 402 is not biodegradable, folder
Pincers may be left in place until clamp comes off through the normal healing process of human body.Or, after the required healing time past,
Can implement individually to perform the operation and remove clamp.
Although explain is the system 400 of related endoscopes, those skilled in the art will will be best understood, described system
System can merged or otherwise be used together with the conduit with any cross section and chamber.
It should be appreciated that the present invention is merely illustrative in many aspects.In the situation without departing from the scope of the invention
Under, can be changed in detail, especially in terms of shape, size and procedure.This can include, in suitable degree
Under, in an exemplary embodiment, the use of any feature can be used in other embodiments.
Claims (20)
1. compress a system for bodily tissue, including:
Mounting rod, described mounting rod includes the draw bail being arranged in endoscope by described mounting rod so that described mounting rod
Along the remote extension of described endoscope, described mounting rod is parallel to the longitudinal axis and is arranged in endoscope；
Clamp, described clamp includes coupling part, and this coupling part has the first and second holder arms extended from it, described folder
Pincers include the recess being formed on the inner surface of described coupling part, and the shape and size of described recess are confirmed as slidably connecing
Receive mounting rod, by contacting between endoscope and the inner surface of described first and second holder arms, described first and second folders
The described inner surface of tong arm is maintained at open position；With
Controlling parts, described control parts are connected to described clamp, to move described clamp along described mounting rod, until described folder
Pincers are moved distally the described far-end exceeding endoscope so that the first and second holder arms elastic closures are to clamp between them
Tissue.
2. the system as claimed in claim 1, the cross sectional shape of wherein said recess meets the cross sectional shape of described mounting rod.
3. system as claimed in claim 2, wherein said recess is one in rectangle, ellipse, circle, T-shaped, and shape has
There are the first and second walls extending into described coupling part with opposite angles, and extend between the first and the second wall
3rd wall, the 3rd wall is one in plane and curved surface, inner surface described in the corresponding described coupling part of the curvature of described curved surface
Curvature.
4. the system as claimed in claim 1, the described inner surface forming part circular arc of wherein said first and second holder arms,
To meet the shape of the outer surface of the described endoscope that described mounting rod is installed on it.
5. the system as claimed in claim 1, the inner surface of wherein said first holder arms includes that surface processes, with strengthen its with
The frictional engagement of the endoscope that described mounting rod is installed on it, described surface processes at inner surface described in described first holder arms
At least some of upper extension.
6. the system as claimed in claim 1, wherein said first and second holder arms deflection arrangement for closed configuration, at described closed
In state, described first and second holder arms move radially inwardly toward contact form, and described clamp has selected spring constant
To keep the frictional engagement of the endoscope being installed on it with described mounting rod.
7. system as claimed in claim 6, wherein said first and second holder arms are installed on it by described mounting rod
Endoscope is maintained at radial dilatation form.
8. the system as claimed in claim 1, the lower surface of wherein said mounting rod is formed has curvature, and described curvature meets institute
State the curvature of the endoscope that mounting rod is installed on it.
9. the system as claimed in claim 1, wherein said recess includes that shoulder, described shoulder prevent described mounting rod and described
Contact between the endoscope that mounting rod is installed on it.
10. the system as claimed in claim 1, the thickness of wherein said clamp is more than the second end to form crescent at the first end
Shape.
11. the system as claimed in claim 1, wherein said clamp includes the spring being formed at described first end, described spring
Including the first and second adjutages to help to clamp the tissue between described first and second holder arms.
12. the system as claimed in claim 1, wherein said draw bail includes circular locking strap, and described locking strap is connected to
Described mounting rod, described mounting rod is removably positioned on the far-end of the endoscope that described mounting rod is installed on it.
13. the system as claimed in claim 1, wherein said control parts include:
Push mechanism, described push mechanism is slidably connected to described mounting rod；With
Seal wire, described seal wire starts to extend from the first end being connected to described push mechanism, is passed through described mounting rod
Passage, to extend into the endoscope that described mounting rod is installed on it, the second end of described seal wire is to connect for user
Touch, to allow the controlled placement of described clamp.
14. systems as claimed in claim 13, farther include guidewire track, and described guidewire track is attached to described mounting rod
And including guiding the track of described seal wire along predefined paths, described guidewire track is positioned at described mounting rod under operation form
In the distal openings of the endoscope being installed on it.
15. the system as claimed in claim 1, farther include the multiple other clamp being positioned on described mounting rod.
16. 1 kinds of devices compressing bodily tissue, including:
Clamp, described clamp includes coupling part, and this coupling part has the first and second holder arms extended from it, described folder
Pincers include the recess being formed on the inner surface of described coupling part, and the shape and size of described recess are confirmed as connecing slidably
Receive the mounting rod of the outer surface being connected to the endoscope that described mounting rod is installed on it, in being installed on it by described mounting rod
Sight glass and with contacting between the inner surface stating the first and second holder arms, the described inner surface of described first and second holder arms
Being maintained at open position, wherein said clamp can slide on the described outer surface of the endoscope that described mounting rod is installed on it,
Until described clamp is moved distally the described far-end exceeding the endoscope that described mounting rod is installed on it so that first and second
Holder arms elastic closure is to clamp the tissue between them.
17. devices as claimed in claim 16, wherein said first and second holder arms deflection arrangement for closed configuration, in described Guan Bi
In form, described first and second holder arms move radially inwardly toward clamping form.
18. 1 kinds of methods compressing bodily tissue, including:
The endoscope being installed on it by mounting rod is advanced to intravital target position, and described endoscope includes multiple being arranged on its appearance
Clamp above face, each clamp includes coupling part, and this coupling part has the first and second holder arms extended from it, institute
Stating the recess that clamp includes being formed on the inner surface of described coupling part, the shape and size of described recess are confirmed as slidably
Receive the described mounting rod of the outer surface being connected to described endoscope, by described endoscope and described first and second holder arms
Inner surface between contact, the inner surface of described first and second holder arms is maintained at open position；
Tissue is incorporated into described endoscope；And
Actuation control parts are with an institute's far-end exceeding described endoscope farthest in sliding described clamp towards distally so that the
One and second holder arms elastic closure be introduced in the tissue of described endoscope with clamping.
19. methods as claimed in claim 18, farther include to activate described control parts to advance described clamp towards distally
In an other far-end exceeding described endoscope so that the first and second holder arms elastic closures are to clamp between them
Tissue.
20. methods as claimed in claim 18, wherein said mounting rod is removably coupled to described endoscope.
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US201461928783P | 2014-01-17 | 2014-01-17 | |
| US61/928,783 | 2014-01-17 | ||
| PCT/US2015/011334 WO2015108926A1 (en) | 2014-01-17 | 2015-01-14 | Clip systems for treating body tissues |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN106132317A true CN106132317A (en) | 2016-11-16 |
| CN106132317B CN106132317B (en) | 2018-11-20 |
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ID=52440873
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201580013866.9A Active CN106132317B (en) | 2014-01-17 | 2015-01-14 | Handle the pincer system of bodily tissue |
Country Status (6)
| Country | Link |
|---|---|
| US (4) | US9848885B2 (en) |
| EP (1) | EP3094266B1 (en) |
| JP (1) | JP6396480B2 (en) |
| CN (1) | CN106132317B (en) |
| CA (1) | CA2937153C (en) |
| WO (1) | WO2015108926A1 (en) |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2020244679A1 (en) * | 2019-06-04 | 2020-12-10 | 北京迈迪顶峰医疗科技有限公司 | Atrial appendage closure apparatus delivery system |
Families Citing this family (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN105193471B (en) * | 2015-08-11 | 2017-10-27 | 北京迈迪顶峰医疗科技有限公司 | Auricle clamp and its conveying device |
| EP4280977A1 (en) * | 2021-07-30 | 2023-11-29 | Boston Scientific Medical Device Limited | Repositionable over the scope clip |
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|---|---|---|---|---|
| US4791707A (en) * | 1986-08-26 | 1988-12-20 | Tucker Wilson H | Clip applicator, spreadable clips and method for applying the clips |
| US5259366A (en) | 1992-11-03 | 1993-11-09 | Boris Reydel | Method of using a catheter-sleeve assembly for an endoscope |
| US5624453A (en) * | 1993-02-23 | 1997-04-29 | Wilson-Cook Medical, Inc. | Endoscopic ligating instrument |
| US5626614A (en) | 1995-12-22 | 1997-05-06 | Applied Medical Resources Corporation | T-anchor suturing device and method for using same |
| US6726704B1 (en) * | 1998-05-29 | 2004-04-27 | By-Pass, Inc. | Advanced closure device |
| US6428548B1 (en) | 1999-11-18 | 2002-08-06 | Russell F. Durgin | Apparatus and method for compressing body tissue |
| US6911032B2 (en) * | 1999-11-18 | 2005-06-28 | Scimed Life Systems, Inc. | Apparatus and method for compressing body tissue |
| US7485124B2 (en) | 2000-10-19 | 2009-02-03 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a fastener delivery mechanism |
| US6645205B2 (en) * | 2001-08-15 | 2003-11-11 | Core Medical, Inc. | Apparatus and methods for reducing lung volume |
| US8945157B2 (en) * | 2009-09-25 | 2015-02-03 | Boston Scientific Scimed, Inc. | Devices for approximating tissue and related methods of use |
| DE102009050829B4 (en) * | 2009-10-27 | 2013-01-24 | Ovesco Endoscopy Ag | resection |
| EP2591736A1 (en) * | 2011-11-14 | 2013-05-15 | Anrei Medical (HZ) Co., Ltd. | Clip apparatus for ligature of living tissue |
| US9301754B2 (en) * | 2012-12-20 | 2016-04-05 | Cook Medical Technologies Llc | Medical device for port closure |
| US20150238194A1 (en) | 2014-02-24 | 2015-08-27 | Boston Scientific Scimed, Inc. | Hemostasis devices and methods utilizing mechanical methods |
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2015
- 2015-01-14 CA CA2937153A patent/CA2937153C/en not_active Expired - Fee Related
- 2015-01-14 JP JP2016547075A patent/JP6396480B2/en active Active
- 2015-01-14 CN CN201580013866.9A patent/CN106132317B/en active Active
- 2015-01-14 WO PCT/US2015/011334 patent/WO2015108926A1/en active Application Filing
- 2015-01-14 EP EP15702059.5A patent/EP3094266B1/en active Active
- 2015-01-14 US US14/596,530 patent/US9848885B2/en active Active
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2020244679A1 (en) * | 2019-06-04 | 2020-12-10 | 北京迈迪顶峰医疗科技有限公司 | Atrial appendage closure apparatus delivery system |
Also Published As
| Publication number | Publication date |
|---|---|
| US11457928B2 (en) | 2022-10-04 |
| CA2937153C (en) | 2018-05-15 |
| CA2937153A1 (en) | 2015-07-23 |
| EP3094266A1 (en) | 2016-11-23 |
| US9848885B2 (en) | 2017-12-26 |
| WO2015108926A1 (en) | 2015-07-23 |
| US20180070951A1 (en) | 2018-03-15 |
| US10575858B2 (en) | 2020-03-03 |
| JP6396480B2 (en) | 2018-09-26 |
| EP3094266B1 (en) | 2018-01-10 |
| US20220401108A1 (en) | 2022-12-22 |
| US20150201946A1 (en) | 2015-07-23 |
| US20200155163A1 (en) | 2020-05-21 |
| JP2017502785A (en) | 2017-01-26 |
| CN106132317B (en) | 2018-11-20 |
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